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Causes – Middle Back Pain

Middle back pain or mid back pain is pain in the back, usually of spinal origin, in a specific part of the back which I have defined as from the sixth thoracic vertebra down to the twelfth thoracic vertebra just above the lumbar spine.

The middle back pain spine area is the lower thoracic spine, an area adapted for rotatory movement and with limited forward and backward motion permitted. The lower half of the rib cage attaches at the back and side of each vertebra in two joints, which when added to the facet joints makes three joints each side at each level, all capable of generating pain.

Although upper areas of the spine can refer pain downwards and give middle back pain, neck joints are not typically involved in pain this far down the back, being able to refer pain down to the base of the shoulder blades. However, it is possible to get chest pain from the thoracic spine or for it to run round to the chest from one or more of the rib joints.

The causes of middle back pain are often not clear but are thought to be mostly joint related in origin with disc problems being very rare. In the lumbar spine disc problems are common but in the mid back the spinal canal is very tightly packed with the spinal cord and any disc protrusions will tend to compress the nerves and give symptoms.

Spinal cord symptoms could include pain or numbness/pins and needles in both legs, unsteadiness, difficulty walking, loss of leg muscle power and bowel and bladder control problems. Any symptoms like this should be reported to your medical advisor at once.

Middle back pain symptoms can vary from sudden and sharp if you overdo a movement in a tight position to an annoying ache which becomes more painful as the posture is held for longer. Poor posture held for too long, such as sitting at a desk or bench or using a computer, can strain the structures in the back and give pain with time.

A physiotherapist can assess and treat the mid back pain area and give mobilisation techniques, manipulation, postural advice and correction and middle back pain exercises to mobilise the joints in the region.

Chiropractors – middle back pain is treated also by this group who adopt a similar approach to other manual therapists but have their own diagnostic labels and manipulation techniques.

Further information about middle back pain can be accessed at Backpainexpert and



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